After ORCH infection, patient-specific antibodies IgM and IgG can rise rapidly, with IgM appearing early and lasting 6-12 weeks, while IgG appears late but can be maintained for life. Therefore, we often regard IgG positivity as a previous infection, while IgM positivity is used as a diagnostic indicator for the first infection.
1. IgG-positive IgM-negative
If the baby has been infected with this virus or has been vaccinated and has developed immunity, it is very unlikely that the baby will be infected.
2.IgG negative IgM negative
This indicates that the pregnant woman is a susceptible person. It is best to repeat the IgG test during pregnancy to observe whether there is a positive turn.
3.IgG-positive IgM-positive
It indicates that the pregnant woman may be primary infected or reinfected. It can be identified by IgG affinity test.
4.IgG-negative IgM-positive
Recent infection or acute infection; may also be false positive IgM caused by other interfering factors. Need to recheck after 2 weeks, such as IgG positive turn, for acute infection, otherwise judged as false positive.
Treatment of various TORCH test results
1.Herpes simplex virus infection
Hazards: Infection in early pregnancy can cause miscarriage or fetal malformation. Its teratogenic effect is weaker than cytomegalovirus infection. Common malformations include eye malformations (such as small eyes, one-eyed, cataracts and optic papillary atrophy), neurological defects (such as cortical atrophy and dementia) and bone and skin damage.
Treatment: If the serum herpes simplex virus is IgM antibody-positive, clearing and detoxifying herbs (e.g. Panax notoginseng) can be used to inhibit the proliferation of the virus and control the infection, and the lesions are painted with 1% gentian violet to keep them dry. Since the chance of the fetus being affected is small, it is usually not necessary to terminate the pregnancy. In principle, cesarean delivery is performed during delivery; even if the lesion has been cured, cesarean delivery is still preferable if the first infection has occurred for less than one month.
2.Rubella infection
The danger: rubella virus infection in early pregnancy can infect the fetus through the placenta, causing miscarriage, intrauterine growth retardation and congenital rubella syndrome.
Congenital rubella syndrome is a fetal malformation syndrome caused by rubella virus infection. It mainly includes eye malformations (such as congenital cataract, microphthalmia, strabismus), small head malformations, congenital heart disease, deafness, cleft palate, short and syndactyly fingers, hypospadias and hemolytic anemia. The earlier a pregnant woman is infected with rubella, the higher the incidence of fetal malformations and the more severe the malformations.
Treatment: Rubella infection (positive serum IgM antibody) in early pregnancy has a high probability of leading to malformed development of the fetus, and the pregnant mother should terminate the pregnancy. If the infection occurs in the middle and late stages of pregnancy, prenatal diagnosis should be conducted to rule out fetal baby infection before continuing the pregnancy, and the pregnant mother should be careful with the medication, mainly symptomatic treatment, and pay attention to avoiding damage to the fetal baby from the medication.
3.Toxoplasma gondii infection
Hazards: Fetal malformations caused by Toxoplasma gondii infection in early pregnancy include hydrocephalus, microcephaly, chorioretinitis and cerebral calcification. Bloodstream infection can cause fetal multi-organ necrotic damage, such as hepatosplenomegaly, myocarditis and thrombocytopenia. Asymptomatic infections can cause intrauterine growth retardation and preterm delivery. Infection in late pregnancy usually does not cause fetal developmental abnormalities.
Treatment: Early pregnancy should be actively tested for Toxoplasma gondii antibodies, and acute infection should be treated with antihelminthic treatment as soon as possible according to medical advice. For those who are positive for Toxoplasma gondii antibody in early and middle pregnancy (within 24 weeks), it is better to abort or give medication to reduce the occurrence of intrauterine infection in the fetus.
4. Cytomegalovirus infection
Hazards: Early pregnancy infection can cause miscarriage and fetal death; middle and late pregnancy infection section causes fetal jaundice, hepatosplenomegaly, cerebellar malformation, hydrocephalus, cerebral softening, cataract, cytomegalovirus pneumonia, congenital heart disease, cleft lip, cleft palate, etc.
Treatment: If the serum cytomegalovirus antibodies are positive for IgM or IgG, both indicate that the pregnant mother is infected. Generally, if the infection is early in pregnancy, the pregnancy can be terminated immediately or wait until 20-24 weeks of gestation for cord blood IgM antibody, cord blood and amniotic fluid pathogen DNA test to find out whether the baby is congenitally infected. If the infection is confirmed, the pregnancy should be terminated at the appropriate time.